TECHNIQUE FOR RECONSTRUCTIVE JEJUNOGASTROPLASTY FOLLOWING GASTRECTOMY ACCORDING TO ROUX IN ACUTELY BLEEDING GASTRIC CANCER

摘要

A technique for the reconstructive jejunogastroplasty following gastrectomy according to Roux in acutely bleeding gastric cancer provides for fashioning intestinal reservoir with duodenal switch. The efferent loop of jejunum is cut proximal to Roux enteroanastomosis at the distance of with the linear stapler "Proximate" . The efferent loop of jejunum is then cut distal to Roux enteroanastomosis. The distal end of jejunum is mobilized on the vascular mesenteric arcade. Enteroanastomosis is transferred proximally retrocolic. The proximal part of the mobilized efferent loop of jejunum is folded in U-shape as the double loop and sutured along 10- with the linear stapler "Proximate" . The sutured double loop is sutured to the distal end of the efferent loop of jejunum distal to esophagojejunoanastomosis along 10- with the linear stapler "Proximate" fashioning the triple loop and the artificial intestinal reservoir (jejunogastroplasty). The efferent loop of jejunum proximal to Roux enteroanastomosis is plugged. The continuity of jejunum is restored with the second end-to-side Roux enteroanastomosis.